Showing posts with label paranoid illness. Show all posts
Showing posts with label paranoid illness. Show all posts

Sunday, September 15, 2013

Snake dreams and the phallic competition with the father

A highly gifted artist who draws cartoons as good as any Disney animator but never made commercial  use of his talents because of a fear of failure and has spent his life - he is now in his mid fifties - in a low clerical position because of the job security it offered brought to therapy the following recurrent dream that he claimed has periodically occurred to him all through his life.

Before telling the dream he added that it makes no sense for him to repeatedly dream of an animal that he detests and dreads when he is awake.

There are two snakes one of which is a diamond headed rattle snake the other one is black.

When asked if in all his dreams there are two snakes he said no: sometimes two, sometimes one, sometimes many. The latest dream had two snakes.

Now a long time back I had read in Karl Abraham's writings that snake in the dreams  often symbolize "phallic competition with the father". I had also once analyzed an Indian man's dream of being chased by a five-headed cobra (shesh naag) which on analysis had shown to be a dread of castration in hands of the father - for daring to compete with him and wish for his death - and the five headedness of the cobra was denial of castration - multiplication of the threatened object, so if one is lost there still will be some in reserve.

So my interest in the dream was piqued to see if this one too will prove to be some form of competition with the father.

"Why it is a diamond headed snake?"

"It may have to do with the triangular shape of the snake's head. Also the scales on its body were full of triangles."

Whether the triangles stood for female genitals could not be confirmed. This avenue was explored because of the theoretical consideration that coming across the female genitals during the Oedipal period in the little boy produces the horror of castration for he immediately concludes that it must be the result of punishment meted out for playing with the genitals (masturbating).

"Why is the other snake black?"

"There was actually a black snake that I once saw crossing across our house. I think it is taken from there."

"Is the diamond headed snake your mother and the black snake your father?"

The patient said it could be but gave no further associations that could confirm or reject the construction.

The patient then stated that recently his paranoid illness has taken an upswing. He feels unmarked black cars, with federal agents inside them, are following him whenever he is on the road. 

Now this patient has had bouts of paranoid breakdowns since the age of 34. These paranoid episodes
always begin with unmarked black cars following him. They quickly escalate into auditory hallucinations in which he is berated for being a pervert who indulges in all kinds of bad sexual practices including child molestation. These accusations have little to do with his manifest sexual behavior for his whole sexual expression is limited to masturbation and even this he does not indulge in more than twice a month. A limit which when exceeded results in paranoid constructions where he is constantly watched by federal agents, security guards, spy cameras, and condemnatory voices, all of which occur, along with a rise in the affect of guilt, to prevent him from indulging in masturbation and the associated [incestuous] fantasies.

His first episode of auditory hallucination began when he was dating a girl at the age of 34. He had only dated once before, a decade earlier, which had ended unsuccessfully because he would repeatedly tell the girl that wouldn't she be better off with somebody else. With this second woman the relationship had almost come to the point of getting engaged but then while having lunch with her in a restaurant in company of his brother with whom he is inseparable he had heard the man on the next table say that he (the patient) was fake and incompetent and should tell the girl he was hoping to marry to go and find somebody better than him. Later that evening the three had gone to the movie and the girl had abruptly left the two of them in the theater and had called off the relationship no doubt sensing his pathological sense of inferiority. Patient had concluded that she had walked out of his life to find somebody who had more money than him. Interestingly he is a millionaire despite his humble job because of a shrewd investment in stock market that he had made in the Eighties. The money though does not have any influence upon his daily living where he is frugal and wears very modest raggedly old clothes.

Few months after the breakup, he had a major paranoid breakdown.

The patient recalled in the session that fateful lunch, that first instance of auditory hallucination, the subsequent full blown paranoid schizophrenia, and then returning to the present told me as to how a woman who works with him, and who was acting quite interested in him had asked for a sum of money and on obtaining had become indifferent again.

"Was the dream sparked by this latest rejection?"

"Yes. Since she gave me hope and then disappeared, a repetition of what has happened to me before, I have been having suspicions that my bedroom is bugged, that there are spy cameras throughout the house, that my television can read my intentions, and the security guards from the campus where I work are standing outside my windows."

This had to be interpreted as due to an escalation of his hostility towards the world because of the latest rejection. He was trying to discharge his anger towards women - his mother was very domineering and had always held him back from taking interest in girls -  through sadomasochistic masturbatory fantasies and which were being controlled out of respect for his parents, for the fantasies were primarily directed against them, through creating paranoid structures of being watched by spy cameras, security guards and black cars. 

Patient at this point recalled that the dreams of snakes almost always occur a day or two before going to the confession. He goes there once a month and mostly to get absolved from the guilt of indulging in masturbation.

Patient was then asked if there were any more details to the dream. All he could think of was that the snakes were under his bed and he was deathly afraid of them.

"What exactly were you afraid the snake would do?"

"They will bite me on my penis," the patient replied.

So the snakes symbolized the father who would castrate him. Though the castration was shown not at the phallic level of psychosexual organization. Instead the great fear had caused a massive regression  all the way to the oral phase, where instead of his penis getting cut off by a human father he was quivering with fear over getting bitten by the snakes (the father substitutes). 

Here one recalls how in Little Han's case the castration fear was being worked through by dreading getting bitten by horses and in Wolf Man's case the castration anxiety had shifted to the fear of getting eaten by wolves.










 

Sunday, May 12, 2013

Paranoid Illness changing into Bipolar Disorder


A woman in her early forties came to her monthly session, primarily to get her medications for she does not like to talk about herself or her illness, and complained that she is once again in her down mood.

"It started a week ago and it is so bad that my son - the only one who still lives at home - left the house. To add insult to injury I flipped my finger at him as he was leaving, which is insane. For the poor boy had done nothing wrong.  All week long I had been on his case. It is good he left on his own because last night given my nasty mood I could have physically kicked his ass out. When I am in that down mood I want nobody around. My son called me this morning to ask if it was safe to return. Thank God he is not upset because he knew it was my mood and not me which was making me behave like that. What lies behind such nastiness of mood?"

Patient denied that anything triggers it. With no leads to go upon as to why she went nasty the session shifted into talking the next thing that was bothering her. It was her anger at her mother. Patient could not be more angry, "She has chest pain but refuses to go to a doctor, treating herself with cold water and aspirin. I am afraid she will die just like my father did."

It too had started a week ago. What came first her worrying about the mother and getting angry over it or her nasty mood.

Patient first claimed that they had started simultaneously but then after being forced to carefully examine had to admit that mother's chest pain had begun a few days earlier. She also recalled that when her anger towards mother could not be contained it was only then some of it had escaped control and despite her best intentions to not do so had begun to get displaced upon her son.

"Why did you think that she will die just like your father?"

"Yes, that is my fear. All I can think of is that she is going to die like my father did. It was traumatic seeing my father die in 2009. He had clogged arteries, just like my mother has."

"Did your mood swings start when your father died?"

"No. His illness and death did not affect me quite that way. I did not get upset. I did not care for him that much. He was not around. For that matter my mother was not around either."

"Then what started the bad moods?"

"The death of my grandmother in 2010. But in the beginning they were not bad moods. It began as a slowly emerging conviction the house in which she had lived and died was haunted. I missed my grandmother very much. She was my real mother. My father and my mother were never really available to me. After her death I started hearing her voice and could feel her presence. I was admitted to the hospital and diagnosed as paranoid schizophrenic because of those voices. They put me on a lot of Seroquel which was the only thing that could block out the hallucinations and allow me to sleep. Even now I am afraid to go off the Seroquel despite your warning that it is making me fat and may cause me diabetes, because I am afraid of the return of the voices.  When I came back from hospital I moved out of my grandmother's house. But her presence followed me to the new house."

"When did the mood swings start?"

"They came gradually. As my fear of my grandmother's presence hovering over me decreased the mood swings started. They are always accompanied by anger towards my mother."

"You became sick after your grandmother's death, but your anger is always directed towards your mother, why is that?"

"Because I think I have a big time grudge against my mother. I loved my grandmother but hated my mother."

"Why you hated your mother?"

"Because she favored my brother over me. He was my half-brother. She preferred him over me, because his father was not around, while mine was,  and she felt he deserved special treatment because of that."

This patient's illness which started as paranoid schizophrenia shows no trace of it now. She is quite warm and social in her interactions when she is not in her down mood. This transformation occurred when she could allow her rage to emerge against her mother. This happened after the death of her grandmother. Prior to that her loving relationship with her grandmother kept her rage bound. Once her grandmother died her rage emerged unchecked and could only be contained through developing a paranoid projection . She started hearing voices that kept her rage from being acted out.  

Once the rage could be expressed against others - the latest being her son - it did not have to be projected and come against her in forms of voices. However since she could not be permanently in a state of rage her psyche developed bipolarity. A time was allotted to be in rage and a time to be nice and good to other people.